In 35 HUP SEEG patients, interictal map agreement with treated contacts did not predict seizure freedom

We tested if an interictal SEEG map identifies the tissue where treatment succeeds. For each of 35 patients (19 seizure-free, 16 not), a leave-one-patient-out logistic model of 18 interictal features gave a score for each bipolar channel. The score predicted the treated (resected or ablated) contacts with median AUC 0.79. But this agreement was not higher in seizure-free patients: outcome AUC 0.41 [0.23, 0.61], one-sided p = 0.81, and 0.51 on a second clip. The clinical SOZ comparators also did not separate outcome (0.51 and 0.55). Single features, a model trained on seizure-free patients only, and the ablation subgroup also gave null results. The study has 80% power only for an outcome AUC of about 0.74 or more. Code, per-patient results, figures and provenance are in the package.

SEEG · epilepsy · interictal activity · seizure outcome · surgical treatment · seizure onset zone · electrophysiology · OpenNeuro